Hamblin Mark J, Horton Maureen R
Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, 1830 East Monument Street, 5th Floor, Baltimore, MD 21205, USA.
Pulm Med. 2011;2011:872120. doi: 10.1155/2011/872120. Epub 2011 Jun 4.
Interstitial lung disease (ILD) is an increasingly recognized complication of rheumatoid arthritis (RA) contributing to significantly increased morbidity and mortality. Diagnosis can be challenging since patients are unlikely to report dyspnea due to an overall decrease in physical activity with advanced arthritic symptoms. Additionally, infections, drug toxicity, and environmental toxins can mimic ILD, creating significant diagnostic dilemmas for the clinician. In this paper we will explore an effective clinical algorithm for the diagnosis of RA-ILD. We will also discuss features of drug-related toxicities, infections, and environmental toxins that comprise the main entities in the differential diagnosis of RA-ILD. Finally, we will explore the known and experimental treatment options that may have some benefit in the treatment of RA-ILD.
间质性肺疾病（ILD）是类风湿关节炎（RA）一种日益被认识到的并发症，会导致发病率和死亡率显著增加。诊断可能具有挑战性，因为由于晚期关节炎症状导致体力活动总体减少，患者不太可能报告呼吸困难。此外，感染、药物毒性和环境毒素可类似ILD，给临床医生带来重大诊断难题。在本文中，我们将探讨一种用于诊断RA-ILD的有效临床算法。我们还将讨论构成RA-ILD鉴别诊断主要实体的药物相关毒性、感染和环境毒素的特征。最后，我们将探讨可能对RA-ILD治疗有一定益处的已知和实验性治疗选择。
